Palliative hypofractionated radiation therapy in incurable head-and-neck cancer patients – 2-year follow-up experience from a tertiary center from South India

Abstract

Purpose: The main aim of the study was to assess tumor response to hypofractionated (HYPO Trial schedule) course of radiotherapy in patients with incurable squamous cell carcinoma of the head and neck in our patients. Materials and Methods: We retrospectively reviewed records of 23 patients treated between January 2019 and December 2019 with hypofractionated radiation therapy. These patients were given palliative radiation if they were deemed to be unsuitable for curative treatment due to poor general condition, comorbidities, advanced stage of disease, and/or advanced age. Radiation therapy schedule was 30 Gy in 5 fractions twice weekly and all the patients were treated with telecobalt machine. The assessment was done clinically. Records of tumor response, mucosal, and skin toxicity noted during radiation therapy and during follow-up were taken from patient records. Results: The most common primary site was oral cavity (48%) followed by oropharynx (31%). Most of the patients presented in Stage IVA (52%) followed by Stage III (31%) at diagnosis. Grades 2 and 3 mucositides were reported in 14 (64%) and 8 (36%), respectively. Eighty percent of the patients had partial response in primary and 65% of the patients had partial response in node. Twenty-seven percent of our patients had stable diseases. Partial response was seen in highest in patients with primary in oral cavity (80%) patients followed by hypopharynx (75%). Conclusion: This regimen offers better symptom palliation, acceptable treatment toxicity and appears practical in centers having a significant proportion of incurable head-and-neck cancer patients.